EP0609606B1 - Tucaresol as an immunopotentiatory agent - Google Patents

Tucaresol as an immunopotentiatory agent Download PDF

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Publication number
EP0609606B1
EP0609606B1 EP93307373A EP93307373A EP0609606B1 EP 0609606 B1 EP0609606 B1 EP 0609606B1 EP 93307373 A EP93307373 A EP 93307373A EP 93307373 A EP93307373 A EP 93307373A EP 0609606 B1 EP0609606 B1 EP 0609606B1
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Prior art keywords
compound
hydroxyphenoxymethyl
formyl
benzoic acid
infection
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EP93307373A
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German (de)
English (en)
French (fr)
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EP0609606A1 (en
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John Richard Rhodes
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Wellcome Foundation Ltd
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Wellcome Foundation Ltd
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Priority claimed from GB929220715A external-priority patent/GB9220715D0/en
Priority claimed from GB929226874A external-priority patent/GB9226874D0/en
Application filed by Wellcome Foundation Ltd filed Critical Wellcome Foundation Ltd
Priority to EP95110267A priority Critical patent/EP0678298A3/en
Publication of EP0609606A1 publication Critical patent/EP0609606A1/en
Priority to US08/460,207 priority patent/US6096786A/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/11—Aldehydes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/12—Ketones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/13—Amines
    • A61K31/155—Amidines (), e.g. guanidine (H2N—C(=NH)—NH2), isourea (N=C(OH)—NH2), isothiourea (—N=C(SH)—NH2)
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/16—Amides, e.g. hydroxamic acids
    • A61K31/165—Amides, e.g. hydroxamic acids having aromatic rings, e.g. colchicine, atenolol, progabide
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/16—Amides, e.g. hydroxamic acids
    • A61K31/18—Sulfonamides
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/185—Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
    • A61K31/19—Carboxylic acids, e.g. valproic acid
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/185—Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
    • A61K31/19—Carboxylic acids, e.g. valproic acid
    • A61K31/195—Carboxylic acids, e.g. valproic acid having an amino group
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/21—Esters, e.g. nitroglycerine, selenocyanates
    • A61K31/215—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/21—Esters, e.g. nitroglycerine, selenocyanates
    • A61K31/215—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids
    • A61K31/235—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids having an aromatic ring attached to a carboxyl group
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/275—Nitriles; Isonitriles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/335—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin
    • A61K31/35—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin having six-membered rings with one oxygen as the only ring hetero atom
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/335—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin
    • A61K31/365—Lactones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/335—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin
    • A61K31/365—Lactones
    • A61K31/366—Lactones having six-membered rings, e.g. delta-lactones
    • A61K31/37—Coumarins, e.g. psoralen
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/41—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
    • A61P1/16—Drugs for disorders of the alimentary tract or the digestive system for liver or gallbladder disorders, e.g. hepatoprotective agents, cholagogues, litholytics
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
    • A61P31/12—Antivirals
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00—Antineoplastic agents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P37/00—Drugs for immunological or allergic disorders
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P37/00—Drugs for immunological or allergic disorders
    • A61P37/02—Immunomodulators
    • A61P37/04—Immunostimulants

Definitions

  • the present invention relates to the use of 4-(2-formyl-3-hydroxyphenoxymethyl) benzoic acid as an immunopotentiatory agent, and the use of, combinations of such a compound with anti-tumour or anti-infective drugs in the prophylaxis or treatment of such diseases arising from tumours or infections.
  • European Patent No. 54924 discloses 4-(2-formyl-3-hydroxyphenoxymethyl)benzoic acid (the compound of formula (I): its synthesis and its properties as a "left-shifter" of the oxygen-dissociation curve. European Patent No. 54924 discloses that the compound of formula (I) increases the affinity of haemoglobin for oxygen causing transient hypoxia in normal and tumour tissue, and can be used in the radiosensitization of tumours. All references identified herein above or in the following are hereby incorporated by reference thereto. The generic name for the compound of formula (I) is tucaresol.
  • the principal protective function of the immune system relates to resistance to invasion by pathogens, including viruses, rickettsia, mycoplasma, bacteria, fungi and parasites of all types.
  • pathogens including viruses, rickettsia, mycoplasma, bacteria, fungi and parasites of all types.
  • a second protective function of the immune system is to resist engraftment of foreign tissue, either natural or in fetal-maternal relationship; or unnatural as performed by the transplant physician.
  • a third protective function of the immune system is thought to be resistance to malignant cell development as in cancer.
  • the use of immunopotentiators in cancer is logical to enhance tumour rejection and to inhibit tumour recurrences following other forms of therapy.
  • a fourth protective function involves maintaining non-reactivity to self by positive suppressor mechanisms.
  • immune reactivity directed at self antigens or exaggerated, elevated responses are apparent which are self destructive.
  • Each of the protective functions of the immune system can be modified by nonspecific therapy with immunopotentiators alone or in combination with other agents employed to improve resistance or to kill the invading pathogen.
  • specific resistance can be augmented by use of immunopotentiators in conjunction with some form of antigen as in a vaccine employing, for example, a virus, tumour cells, etc. This use can be to induce either specific immunity or tolerance.
  • the latter is exemplified by use with an antigen in allergy or an auto-immune disease.
  • Use of immunopotentiators may be either therapeutic or prophylactic; the latter is used particularly in the elderly, where infection, auto-immunity, and cancer are more common.
  • the timing and route of administration are critical in determining whether a positive or negative response results. Any agent capable of augmenting an immune response may inhibit it depending on timing and dose; thus, under certain circumstances an immunopotentiator could be used as an immunosuppressive agent for use in allergy, auto-immunity and transplantation.
  • immunopotentiator an agent which is capable of restoring a depressed immune function, or enhancing normal immune function, or both. However because of certain elements of the immune system an immunopotentiator can also have immunosuppressive effects.
  • Immune responses are orchestrated by T lymphocytes whose stereo-specific receptors are triggered by antigenic fragments bound to specialised molecules (MHC) on the surface of antigen presenting cells.
  • MHC specialised molecules
  • Tcells require costimulatory signals which are provided by antigen-presenting cells.
  • the interaction between antigen-presenting cells and T-cells involves accessory adhesion molecules some of which are linked to the T-cell receptor:antigen-MHC interaction and others which are separate from this interaction. Some of these adhesion molecules provide costimulatory signals.
  • in vitro studies have established that transient covalent, chemical reactions between cell surface ligands are essential in the antigen- specific activation of T cells (Rhodes, J.
  • salts of the compound of formula (I) the biological activity resides in ether (anion) moiety and the identity of the cation is of less importance although for use in medicine it is preferably pharmacologically acceptable to the recip- itent.
  • Suitable salts include ammonium salts, alkali metal salts such as sodium and potasium salts, and salts formed with organic bases.
  • the compound of the invention or physiologically acceptable salts thereof may be used for the treatment of diseases where there is a defect in the immune system and/or an ineffective host defence mechanism, or to enhance activity of the immune system above normal levels.
  • the present invention provides for the use of 4-(2-formyl-3-hydroxyphenoxymethyl) benzoic acid or physiologically acceptable salts thereof for the manufacture of a medicament for the potentiation of an immune response.
  • Immune function is defined as the development and expression of humoral (antibody- mediated) immunity, cellular (T-cell-mediated) immunity, or macrophage and granulocyte mediated resistance.
  • immunodeficient patient will be used to describe patients with a deficient or defective immune system.
  • An immunodeficient patient can be characterised by means of a T-iymphocyte proliferation assay. Using this assay immunodeficient patients are characterised by a reduced ability of the T cells to respond to stimulation by mitogens and recall antigens.
  • An example of a mitogen commonly used in this assay is phytohaemagglutinin (PHA) and tetanus toxoid respectively.
  • SI Stimulation Index
  • immune system deficiency is common in immature or premature infants (neonates). It may also result from suppression by certain drugs, which may be deliberate e.g. as a side-effect of cancer chemotherapy. Disordered growth of one or more constituent parts of the immune system, e.g. as in certain forms of cancer, may also result in immunodeficiency. Immune deficiency may furthermore be caused by viral infections, including human immunodeficiency virus (HIV).
  • HIV human immunodeficiency virus
  • the compound of formula (I) or physiologically acceptable salts may be administered for the treatment or prophylaxis of immunodeficient mammals alone or in combination with other therapeutic agents, for example, with other antiviral agents, or with other anticancer agents.
  • the present invention is applicable to the treatment of viral hepatitis in all of its forms, five types now being recognised hepatitis A, B, C, D and E respectively.
  • HSV herpes simplex virus
  • VZV varicella zoster virus
  • CMV cytomegalovirus
  • EBV Epstein-Barr virus
  • HHV6 human herpes virus 6
  • HSV 1 and HSV 2 are some of the most common infectious agents of man. Most of these viruses are able to persist in the host's neural cells; once infected, individuals are at risk of recurrent clinical manifestations of infection which can be both physically and psychologically distressing.
  • HSV infection is often characterised by extensive and debilitating lesions of the skin, mouth and/or genitals. Primary infections may be subclinical although tend to be more severe than infections in individuals previously exposed to the virus. Ocular infection by HSV can lead to keratitis or cataracts thereby endangering the host's sight. Infection in the newborn, in immunocompromised patients including AIDS patients or penetration of the infection into the central nervous system, can prove fatal.
  • VZV Varicella zoster
  • Chickenpox is the primary disease produced in a host without immunity and in young children is usually a mild illness characterised by a vesicular rash and fever.
  • Shingles or zoster is the recurrent form of the disease which occurs in adults who were previously infected with varicella-zoster virus.
  • the clinical manifestions of shingles are characterised by neuralgia and a vescicular skin rash that is unilateral and dermatomal in distribution. Spread of inflammation may lead to paralysis or convulsions. Coma can occur if the meninges becomes affected.
  • VZV may disseminate causing serious or even fatal illness.
  • VZV is of serious concern in patients receiving immunosuppressive drugs for transplant purposes or for treatment of malignant neoplasia and is a serious complication of AIDS patients due to their impaired immune system.
  • CMV infection with CMV leads to a lifelong association of virus and host and, following a primary infection, virus may be shed for a number of years.
  • Congenital infection following infection of the mother during pregnancy may give rise to clinical effects such as death or gross disease (microcephaly, hepat- osplenomegaly, jaundice, mental retardation), retinitis leading to blindness or, in less severe forms, failure to thrive, and susceptibility to chest and ear infections.
  • CMV infection in patients who are immunocompromised for example as a result of malignancy treatment with immunosuppressive drugs following transplantation or infection with HIV may give rise to retinitis, pneumoitis, gastrointestinal disorders and neurological diseases.
  • CMV infection in AIDS patients is a predominant cause of morbidity in 50-80% of the adult patient population, it is present in a latent form and can be reactivated in immunocompromised patients.
  • Epstein-Barr virus causes infectious mononucleosis and hairy leukoplakis, and is also suggested as the causative agent of human cancer, such as nasopharyngeal cancer, immunoblastic lymphoma, Burkitt's lymphoma.
  • HBV is a viral pathogen of world-wide major importance.
  • the virus is aetiologically associated with primary hepa- tocellular carcinoma and is thought to cause about 80% of the world's liver cancer.
  • the United States currently contains an estimated pool of 500,000 to 1-million infectious carriers.
  • Chronic active hepatitis generally develops in over 25% of carriers, and often progresses to cirrhosis.
  • Clinical effects of infection with HBV range from headache, fever, malaise, nausea, vomiting, anorexia and abdominal pains.
  • Replication of the virus is usually controlled by the immune response, with a course of recovery lasting weeks or months in humans, but infection may be more severe leading to persistent chronic liver disease outlined above.
  • Retroviruses form a sub-group of RNA viruses which, in order to replicate, must first 'reverse transcribe' the RNA of their genome into DNA ('transcription' conventionally describes the synthesis of RNA from DNA). Once in the form of DNA, the viral genome may be incorporated into the host cell genome, allowing it to take advantage of the host cell's transcription/translation machinery for the purposes of replication. Once incorporated, the viral DNA is virtually indistinguishable from the host's DNA and, in this state, the virus may persist for the life of the cell.
  • prophylaxis may be required by those diagnosed as seropositive for HIV i.e. having antibodies to HIV, and those with PGL (progressive generalised lymphadenopathy) or ARC (AIDS-related complex) as well as patients suffering from AIDS or patients suffering from AIDS-like immune deficiencies where the HIV infection is not detectable and who also require immunorestoration by means that are not specific to any particular virus.
  • PGL progressive generalised lymphadenopathy
  • ARC AIDS-related complex
  • Combination therapies according to the present invention comprise, the administration of at least one compound of the formula (I) or a physiologically functional derivative thereof and at least one other pharmaceutically active ingredient.
  • the active ingredient(s) and pharmacologically active agents may be administered together or separately and, when administered separately this may occur simultaneously or sequentially in any order.
  • the amounts of the active ingredient(s) and pharmacologically active agents(s) and the relative timings of administration will be selected in order to achieve the desired combined therapeutic effect.
  • the combination therapy involves the administration of one compound of the formula (I) or a physiologically functional derivative thereof and one of the agents mentioned herein below.
  • agents that are effective for the treatment of HIV infections or associated conditions such as 3'-azido-3'-deoxythymidine (zidovudine), other 2', 3'-dideoxynucleosides such as 2',3'- didoxycytidine, 2',3'-dideoxyadenosine and 2',3'-didoxyinosine, carbovir, acyclic nucleosides (for example, acyclovir), 2',3'-didehydrothymidine, protease inhibitors such as N-tert-butyl-dechydro-2-[-2(R)-hydroxy-4-phenyl-3(S)-[[N-2-quinolyl-carbonyl)-L-asparginyl]butyl]-(4aS,8aS)-isoquinoline-3(S)-carboxamide (Ro 31-8959), oxathiolan nucleoside analogues
  • Such further therapeutic agents which are effective for the treatment of HBV infections include carbovir, oxathiolan nucleoside analogues such as cis-1-(2-hydroxymethyl)-1,3-oxathiolan-5-yl)-cytosine or cis-1-(2-(hydroxymethyl)-1,3-oxathiolan-5-yl-5-fluoro-cytosine, 2',3'-didoxy-5-ethynyl-3'-fluorouridine, 5-chloro-2',3'-didoxy-3'-fluorouridine, 1-(p-D-arabinofuranosyl)-5-propynyluracil, acyclovir and interferons, such as a interferon.
  • oxathiolan nucleoside analogues such as cis-1-(2-hydroxymethyl)-1,3-oxathiolan-5-yl)-cytosine or cis-1-(2-(hydroxymethyl)-1,3-o
  • the present invention provides the use of the compound of formula (I) and physiologically acceptable salts thereof for the manufacture of a medicament for the treatment and/or prophylaxis of Pneumocvstis carinii infections in mammals (including humans).
  • the compound of formula (I) or physiologically acceptable salts thereof can also be used for the treatment and prophylaxis of cancer, at a daily dosage substantially lower and for a longer duration than the dosage used previously disclosed in EP 54924.
  • the duration of dosing for the treatment and prophylaxis of cancer using a compound of the invention is longer than would be required for radiosensitisation.
  • cancers particularly suitable for treatment with the compound of formula (I) are : melanoma, cervical cancer, breast cancer, colon cancer, cancer of the head and neck, gastric cancer, renal cancer, laryngeal cancer, rectal cancer, and non-Hodgkins lymphoma. Cancers that express tumour specific antigens or antigens rarely expressed or expressed at very low density on normal cells, are likely therapeutic targets. Cancers which contain tumour specific cytotoxic T-celis which are anergic or otherwise ineffective are likely targets for therapy Surgically resected tumours where there is a high risk of recurrence are also suitable for therapy with the compound of formula (I). Also early stage cancer patients with minimal disease or localised disease are suitable for therapy.
  • the compound of formula (I) is thought to act by providing a co-stimulatory signal to cloned (partially) activated T- cells in vitro, thus maximally activating T-cells.
  • the compound of formula (I) may be administered to the human recipient by a route selected from oral, parenteral (including subcutaneous, intradermal, intramuscular and intravenous), rectal and inhalation.
  • a route selected from oral, parenteral (including subcutaneous, intradermal, intramuscular and intravenous), rectal and inhalation The size of an effective dose of a compound will depend upon a number of factors including the identity of the recipient, the type of immunopotentiation involved, the severity of the condition to be treated and the route of administration, and will ultimately be at the discretion of the attendant physician.
  • such an effective dose will generally be in the range 0.5 to 50 mg/kg bodyweight of human recipient per day, preferably in the range 1 to 20 mg/kg bodyweight per day and most preferably in the range 1 to 10 mg/kg bodyweight per day; an optimum dose is 3 mg/kg bodyweight per day
  • the above doses are for a human usage.
  • the desired dose may be presented as between two and four sub-doses administered at appropriate intervals throughout the day.
  • three sub-doses are employed each will generally lie in the range .03mg to 33mg, preferably 0.16mg to 166mg and most preferably 0.3 to 6.6mg (acid)/kg bodyweight with an optimum of 1.0mg (acid)/kg bodyweight.
  • a daily dose for a human weighing of the order of 50 kg will thus generally lie in the range 5mg to 5g (acid), preferably in the range 25mg to 2.5g (acid) and most preferably in the range 50mg to 1 g (acid).
  • a human daily dose is 150mg (acid).
  • the desired dose is preferably presented as a daily dose, over a period of at least 5 days, most preferably over a period of at least 28 days.
  • the formulations of the present invention comprise a compound of formula (I), as above defined, together with one or more acceptable carriers therefor and optionally other therapeutic ingredients.
  • the carrier(s) must be 'acceptable' in the sense of being compatible with the other ingredients of the formulation and not deleterious to the recipient thereof.
  • the formulations include those suitable for oral, parenteral (including subcutaneous, intradermal, intramuscular and intravenous) and rectal administration although the most suitable route may depend upon for example the condition of the recipient.
  • the formulations may conveniently be presented in unit dosage form and may be prepared by any of the methods well known in the art of pharmacy. All methods include the step of bringing into association the compound of formula (I) (the active ingredient) with the carrier which constitutes one or more accessory ingredients.
  • the formulations are prepared by uniformly and intimately bringing into association the active ingredient with liquid carriers or finely divided solid carriers or both, and then, if necessary, shaping the product into the desired formulation.
  • Formulations of the present invention suitable for oral administration may be presented as discrete units such as capsules, cachets or tablets each containing a predetermined amount of the active ingredient; as a powder or granules; as a solution or a suspension in an aqueous liquid or a non-aqueous liquid; or as an oil-in-water liquid emulsion or a water-in-oil liquid emulsion.
  • the active ingredient may also be presented as a bolus, electuary or paste.
  • a tablet may be made by compression, or moulding, optionally with one or more accessory ingredients.
  • Compressed tablets may be prepared by compressing in a suitable machine the active ingredient in a free-flowing form such as a powder or granules, optionally mixed with a binder, lubricant, inert diluent, lubricating, surface active or dispersing agent.
  • Moulded tablets may be made by moulding in a suitable machine a mixture of the powdered compound moistened with an inert liquid diluent.
  • the tablets may optionally be coated or scored and may be formulated so as to provide slow or controlled release of the active ingredient therein.
  • Formulations for parenteral administration include aqueous and non-aqueous sterile injection solutions which may contain antioxidants, buffers, bacteriostats and solutes which render the formulation isotonic with the blood of the intended recipient; and aqueous and non-aqueous sterile suspensions which may include suspending agents and thickening agents.
  • the formulations may be presented in unit-dose or multi-dose containers, for example sealed ampoules and vials, and may be stored in a freeze-dried (lyophilized) condition requiring only the addition of the sterile liquid carrier, for example water for injections, immediately prior to use.
  • Extemporaneous injection solutions and suspensions may be prepared from sterile powders, granules and tablets of the kind previously described.
  • Formulations for rectal administration may be presented as a suppository with the usual carriers such as cocoa butter.
  • European Patent No. 54924 contains no invitation to administer the compound of formula (I) by the nasal or pulmonary route nor any suggestion that the said compound, if administered in such a manner, would be effective in the treatment of the conditions therein taught; the said disclosure likewise contains no description of any formulation suitable for administration by the nasal or pulmonary route.
  • Formulations suitable for pulmonary administration via the buccal cavity are presented such that particles containing the active ingredient and desirably having a diameter in the range 0.5 to 7 microns are delivered into the bronchial tree of the receipient.
  • such formulations are in the form of finely comminuted powders which may conveniently be presented either in a pierceable capsule, suitably of for example gelatin, for use in an inhalation device, or alternatively as a self-propelling formulation comprising active ingredient, a suitable liquid propellant and optionally other ingredients such as surfactant and/or a solid diluent.
  • Self-propelling formulations may also be employed wherein the active ingredient is dispensed in the form of droplets of a solution or suspension.
  • Such self-propelling formulations are analogous to those known in the art and may be prepared by established procedures. Suitably they are presented in a container provided with either a mannually-operable or automatically functioning valve having the desired spray characteristics; advantageously the valve is of a metered type delivering a fixed volume, for example 50 to 100 microlitres, upon each operation thereof.
  • the active ingredient may be in the form of a solution for use in an atomiser or nebuliser whereby an accelerated airstream or ultrasonic agitation is employed to produce a fine droplet mist for inhalation.
  • Formulations suitable for nasal administration include presentations generally similar to those described above for pulmonary administration. When dispensed such formulations should desirably have a particle diameter in the range 10 to 200 microns to enable retention in the nasal cavity; this may be achieved by, as appropriate, use of a powder of a suitable particle size or choice of an appropriate valve. Other suitable formulations include coarse powders having a particle diameter in the range 20 to 500 microns, for administration by rapid inhalation through the nasal passage from a container held close up to the nose, and nasal drops comprising 0.2 to 5% w/v of the active ingredient in aqueous or oily solution.
  • Preferred unit dosage formulations are those containing an effective dose, as hereinabove recited, or an appropriate fraction thereof, of the active ingredient.
  • Dissolve the compound of formula (I) as for injections Sterilize the solution by passage through a membrane filter, 0.21 m pore size, collecting the filtrate in a sterile receiver. Fill into sterile glass ampoules, lOmUampoule, under aseptic conditions and seal each ampoule by fusion of the glass.
  • the propellant is a commercially available mixture of trichloromono- fluoromethane, dichlorodifluoromethane and dichlorotetrafluoroethane.
  • the micronised compound of formula (I) could be compressed into a plug and a device which delivers small amounts of the compound of formula (I) into the airstream can be used.
  • the Compound, Lactose and Starch are mixed together and then granulated with a solution of Polyvinyl-pyrrolidone in water. After drying the granules, the Magnesium Stearate is mixed in and tablets compressed at an average weight of 260 mg.
  • the Compound, Dibasic Calcium Phosphate, Dihydrate and Sodium Starch Glycolate are mixed together and then granulated with a solution of the Methylcellulose in water. After drying, the granules are mixed with the Stearic Acid and Talc and the mixture filled into gelatin capsules at an average fill weight of 230 mg.
  • Preferred unit dosage formulations are those containing a daily dose or unit daily sub-dose, as hereinabove recited, or an appropriate fraction thereof, of a compound of formula (I) or physiologically acceptable salts thereof.
  • formulations of this invention may include other agents conventional in the art having regard to the type of formulation in question, for example those suitable for oral administration may include flavouring agents.
  • the compound of formula (I) or physiologically acceptable salts thereof may also be presented as depot formulations of the kind known in the art from which the active ingredient is released, over a prolonged period, once the formulation is in place within the body of the recipient.
  • mice were injected subcutaneously in the dorsal mid-line either with antigen alone, with antigen plus a conventional adjuvant, or with antigen plus test compound. Subsequent additional injections of test compound were also given where specified for up to four days at the same injection site. After seven days regional (inguinal) lymph nodes were removed and the lymph node cells restimulated with antigen alone. Antigen specific proliferation of lymphocytes was measured after a further four days by a standard procedure employing 3 H-thymidine uptake into DNA and liquid scintillation spectrometry Tests for humoral immunity were performed by administering antigen and test compounds in the same way. After 1-2 weeks blood was sampled by venepuncture and serum antibody was assayed by an enzyme-linked immunosorbent (ELISA) assay RESULTS
  • ELISA enzyme-linked immunosorbent
  • the data in figure 1 show the effects of the compound of formula (I) on T-lymphocyte priming to antigen (keyhole limpet haemocyanin).
  • B10S mice received 50gg of antigen either alone ( ⁇ ), with the conventional adjuvant alum (0), or with 100 ⁇ g of compound of formula (I) (•).
  • Compound of formula (I) is also known as tucaresol.
  • the compound of formula (I) was dissolved in PBS by dropwise addition of 1 M KOH to pH 10.0 followed by dropwise addition of conc. HCI to return pH to neutral. Solutions were injected within 1 hour of preparation.
  • tumour growth diffuse granular rendered calliper measurements of volume, meaningless and such data are therefore not included.
  • mice Eight week old female Balb/c mice received five daily injections of tucaresol each containing either 100 ⁇ g, ( ⁇ ) 200 ⁇ g (*) or 1 mg (0) of the drug intraperitoneally starting on day 0.
  • a control group received no drug ( ⁇ ). All mice were immunized subcutaneously on day 0 with 5 ⁇ g of KLH.
  • An additional control group received no drug and no KLH ( 0 ).
  • mice were immunised subcutaneously in the dorsal mid-line at the base of the tail with 10 ⁇ g of Keyhole limpet haemocyanin (KLH).
  • KLH Keyhole limpet haemocyanin

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EP93307373A 1992-10-01 1993-09-17 Tucaresol as an immunopotentiatory agent Expired - Lifetime EP0609606B1 (en)

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EP95110267A EP0678298A3 (en) 1992-10-01 1993-09-17 Use of 4- (2-formyl-3-hydroxyphenoxymethyl) benzoic acid as an immunopotentiating agent.
US08/460,207 US6096786A (en) 1992-10-01 1995-06-02 Immunopotentiatory agent and physiologically acceptable salts thereof

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GB929220715A GB9220715D0 (en) 1992-10-01 1992-10-01 Immunopotentiatory agent and physiologically acceptable salts thereof
GB9220715 1992-10-01
GB9226874 1992-12-23
GB929226874A GB9226874D0 (en) 1992-12-23 1992-12-23 Immunopotentiatory agents and physiologically acceptable salts thereof

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EP95110267A Withdrawn EP0678298A3 (en) 1992-10-01 1993-09-17 Use of 4- (2-formyl-3-hydroxyphenoxymethyl) benzoic acid as an immunopotentiating agent.
EP93921034A Withdrawn EP0614357A1 (en) 1992-10-01 1993-09-30 Immunopotentiatory agents

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GR3022541T3 (en) 1997-05-31
HRP931243A2 (en) 1995-12-31
IL107157A0 (en) 1993-12-28
EP0678298A3 (en) 1996-05-29
WO1994007479A2 (en) 1994-04-14
ES2096215T3 (es) 1997-03-01
AU4831193A (en) 1994-04-26
SK65294A3 (en) 1995-03-08
YU62793A (sh) 1998-05-15
CN1091005A (zh) 1994-08-24
DE69306545D1 (de) 1997-01-23
HU9401631D0 (en) 1994-08-29
CA2124677C (en) 2008-09-09
JPH07504204A (ja) 1995-05-11
JPH072660A (ja) 1995-01-06
DK0609606T3 (enrdf_load_stackoverflow) 1997-03-17
CZ132794A3 (en) 1995-02-15
CN1213746C (zh) 2005-08-10
ATE146075T1 (de) 1996-12-15
SI9300514A (en) 1994-06-30
RU94028670A (ru) 1996-05-20
JP3717950B2 (ja) 2005-11-16
KR100348775B1 (ko) 2003-02-11
DE69306545T2 (de) 1997-04-03
EP0609606A1 (en) 1994-08-10
EP0678298A2 (en) 1995-10-25
SG48993A1 (en) 1998-05-18
CA2124677A1 (en) 1994-04-14
AU676491B2 (en) 1997-03-13
HUT70482A (en) 1995-10-30
US5508310A (en) 1996-04-16
NZ256110A (en) 1997-07-27
EP0614357A1 (en) 1994-09-14
MX9306079A (es) 1994-06-30

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